<div class="page-header">
    <h1>Đăng ký</h1>
</div>
<form action="#" class="form-horizontal">
    <div class="panel panel-info">
        <div class="panel-heading">
            <h3 class="panel-title">Thông tin tài khoản</h3>
        </div>
        <div class="panel-body">
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="user">Tên tài khoản</label>
                </div>

                <div class="col-xs-6">
                    <input type="text" id="inputUser" Class="form-control" placeholder="Tên tài khoản">
                </div>

            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="password">Mật khẩu</label>
                </div>

                <div class="col-xs-6">
                    <input type="password" id="inputPass" Class="form-control" placeholder="Mật khẩu">
                </div>

            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="password">Nhập lại mật khẩu</label>
                </div>

                <div class="col-xs-6">
                    <input type="password" id="inputRePass" Class="form-control" placeholder="Nhập lại mật khẩu">
                </div>

            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="email">Email</label>
                </div>

                <div class="col-xs-6">
                    <input type="email" id="inputEmail" Class="form-control" placeholder="Email">
                </div>
            </div>

            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="email">Nhập lại Email</label>
                </div>                        
                <div class="col-xs-6">
                    <input type="email" id="inputReEmail" Class="form-control" placeholder="Nhập lại Email">
                </div>
            </div>
        </div>
    </div>
    <div class="panel panel-info">
        <div class="panel-heading">
            <h3 class="panel-title">Thông tin cá nhân</h3>
        </div>
        <div class="panel-body">
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="name">Họ tên</label>
                </div>                        
                <div class="col-xs-4">
                    <input type="text" id="inputName" Class="form-control" placeholder="Họ tên">
                </div>
                <div class="col-xs-2">
                    <select class="form-control input-sm" id= "sex">
                        <option value="0">Giới tính</option>
                        <option value="1">Nam</option>
                        <option value="2">Nữ</option>
                    </select>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="bDay">Ngày sinh</label>
                </div>                        
                <div class="col-xs-2">
                    <select class="form-control input-sm" id="day">
                        <option value="0">Ngày</option>
                        <?php
                        for ($i = 1; $i <= 31; $i++) {
                            ?> 
                            <option value="<?php echo $i ?>"><?php echo $i; ?></option> 
                            <?php
                        }
                        ?>
                    </select>
                </div>
                <div class="col-xs-2">
                    <select class="form-control input-sm" id="month">
                        <option value="0">Tháng</option>
                        <?php
                        for ($i = 1; $i <= 12; $i++) {
                            ?> 
                            <option value="<?php echo $i ?>"><?php echo $i; ?></option> 
                            <?php
                        }
                        ?>
                    </select>
                </div>
                <div class="col-xs-2">
                    <select class="form-control input-sm" id="year">
                        <option value="0">Năm</option>
                        <?php
                        for ($i = 2014; $i > 1970; $i--) {
                            ?> 
                            <option value="<?php echo $i ?>"><?php echo $i; ?></option> 
                            <?php
                        }
                        ?>
                    </select>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="numPhone">Số điện thoại</label>
                </div>

                <div class="col-xs-6">
                    <input type="text" id="inputNumPhone" Class="form-control" placeholder="Số điện thoại">
                </div>

            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="address">Địa chỉ</label>
                </div>

                <div class="col-xs-6">
                    <input type="text" id="inputAddress" Class="form-control" placeholder="Địa chỉ">
                </div>

            </div>
        </div>
    </div>
    <div class="panel panel-info">
        <div class="panel-heading">
            <h3 class="panel-title">Quy định</h3>
        </div>
        <div class="panel-body">

            <div class="panel panel-default">
                <div class="panel-body">
                    <div class="col-xs-9" style="height:100px;overflow:auto;">
                        Nội dung.....
                    </div>
                </div> 
            </div>
            <div class="checkbox col-xs-10">

                <label>
                    <input type="checkbox" id="rules">Tôi đồng ý với quy định của Gia sư 7s
                </label>
            </div>
        </div>
    </div>

    <div class="form-group">
        <div class="col-xs-3"></div>
        <div class="col-xs-3">
            <button type="submit" class="btn btn-primary btn-lg btn-block">Đăng ký</button>
        </div>
        <div class="col-xs-2">
            <button type="reset" class="btn btn-default btn-lg btn-block">Hủy</button>
        </div>


    </div>
</form>